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The purpose of this paper is to strengthen the role of management supervision in the competence of management and its support. Competence in organizations consists of the human, social and structural dimensions. It involves controlling explicit and tacit knowledge, know‐how and experiences. Competence‐based management requires the ability to manage, as well as the skills to consider, build, evaluate, support and leverage competence in an organization. The competence and well‐being of a manager needs to be supported.

The study represented in this article is a qualitative comparison and the new knowledge of experienced material has been evaluated. It is done during two periods and based on interviews with public and private managers in social and health services (n=22 and n=12). The data have been analysed through the use of content analysis inspired by the theory and the data.

Management supervision includes dialogue and reflective thinking as features of competence‐based management and its development. It is a strategic method of support for management and at the same time is a part of a manager's welfare. Management supervision as one support system clarifies strategic competence‐based management, gives support to leadership know‐how and helps a manager to feel better at work.

Because strategic competence based management in social and health care organizations is a very demanding and multidimensional function, it needs a lot of support. Management supervision is a strategic method of support for management and at the same time is a part of a manager's welfare. The significance of this method should be emphasized more in the management of social and health services.

The allocation of resources is a complex problem in health care. In Finland there has been an effort to solve the problems with a program called “Securing the Future of Health Care”. The main focus of this research is on assessing how managers view the health care policy called guarantee of care from an ethical perspective.

The theoretical basis of the research covers theories regarding rationing, prioritization, as well as the ethics of health care. The empirical data were gathered through an internet questionnaire. The questionnaires were sent to the top managers in all Finnish health care districts (20 in all). The data were analyzed qualitatively.

According to respondents, ensuring access to treatment partially fulfilled the ethical principles of the right to good care, respect for human dignity, fairness, and co‐operation and mutual respect quite well. On the other hand, trust, impressiveness, non‐partiality in decision making and the right of self‐determination were not as well realized. The shortening of waiting lists had caused exhaustion and motivation problems among personnel and in addition, staff shortages were being experienced.

The administrators of the hospital districts agreed that centralizing resources as a reconstructive action is ethically wrong for the whole health care system. There is a great need for an ethical discussion concerning the choices made in health care policy. Long‐term results need sustainable solutions.